Brain injury is more common than you might think and it is often called the hidden disability because it is not always obvious.

What causes a brain injury?

There are a whole range of causes.

Traumatic brain injury

Some injuries are very obvious like a major trauma where people have a direct blow to the head of one sort or another.

Injuries could be caused by:

• An assault
• A fall
• A car accident
• A sport injury

These types of injuries are caused by the skull being fractured and brain being directly damaged, or the brain being moved sharply within the skull that can damage the nerve and brain tissue.

Acquired brain injury

An acquired brain injury is one that occurs after birth, but is not a trauma. An ABI can be caused by infection or disease, for instance meningitis or encephalitis.

Other causes can be:

• Brain tumour
• Stroke and other cardio vascular causes
• Near drowning or choking where oxygen fails to reach the brain
• Toxic affects
• Metabolic disorders
• Blood loss

And there are many, many more.

What are the physical effects of a brain injury?

Broadly speaking there are three main areas:

• Physical - affecting how the body works
• Cognitive - affecting how the person thinks learns and remembers
• Emotional and behavioural - affecting how the person feels and acts

Some of the physical effects are:

Fatigue

Excessive tiredness is common to all severities of brain injury, including mild injuries. Tasks we take for granted, like dressing or walking around, can require much more effort after a brain injury. It is important to rest at regular intervals.

Mobility

Movement can become very slow and balance can be affected. Some people may need a wheelchair or other mobility aids because their balance and co-ordination may mean they cannot walk without support.

Sensory impairment

The touch sensation may be lost, reduced or exaggerated. It may also be difficult to know where limbs are positioned. Eyesight can be affected and this may not be correctable with glasses. Odd postures or walking patterns may also be explained by sensory impairments. Taste or sense of smell may also be impaired, in the short or long term.

Difficulties with speech

Slow, indistinct or rapid speech is common. It may be hard to understand the person’s speech at first. Some people may repeat what they have said many times over. Some people lose the ability to speak altogether.

Epilepsy

After a brain injury, a person can be prone to epileptic seizures or fits. Sometimes, if the person is given drugs to reduce the chance of seizures reoccurring, this can also dampen their level of arousal and performance of everyday tasks. This is in addition to the excessive fatigue they may have due to their brain injury.

Other effects

Other effects might be weakness or paralysis, often affecting one side of the body; ataxia which can be irregular, uncontrolled movement or tremor affecting coordination; hormonal imbalances.

Some cognitive effects are:

Problems with memory

Problems with memory, particularly short term memory are common after brain injury. Some people may be unable to remember faces or names, or what they have read or what has been said to them.

Reduced concentration span

This is very common and can also impact on memory problems. Completing tasks can be a problem and the task may be abandoned before reaching the end.

Reduced speed of information processing

People can take longer to think things through, or work out what has been said to them.

Reduced problem-solving ability

It may be difficult for the person to work out what to do, especially if they encounter an unexpected problem.

Impaired judgement and reasoning

A brain injury may impair a person’s ability to think logically, to understand rules and follow discussions. It can cause difficulties in accurately perceiving and interpreting one’s own and other people’s behaviour and feelings.

Lack of insight

The person may have unrealistic view of themselves and others and may not appreciate that they have certain problems.

Language loss (aphasia)

This may be a receptive difficulty (making sense of what is said or read) or an expressive difficulty (finding the right words to say or write), or both.

Impairments in visual-perceptual skills

The person may have difficulty making sense out of ordinary pictures and shapes, finding the way around buildings, or drawing or constructing objects. Occasionally, people may fail to respond to stimuli coming from one side of their visual field, or may ignore a particular side of their body, for example when shaving or dressing.

Some emotional and behavioural effects:

Loss of confidence

This is very common after a brain injury.

Mood swings

The person may have a tendency to laugh or cry very easily and to move from one emotional state to another quite quickly.

Depression and sense of loss

This is quite common. Depression may be caused by an injury to the areas of the brain that control emotion, but can also be associated with the person gaining an insight into the other effects of their injury. After an injury, many things that are precious to the individual may be lost forever and there may be sadness, anger, guilt and confusion.

Anxiety, frustration and anger

Life has changed forever in a matter of seconds and the future can look frightening. Anxiety can quickly turn to frustration and anger and needs to be identified and alleviated as early as possible. The resulting anger may be very difficult for the person to control.

Abusive or obscene language

This may be spontaneous and uncontrollable and may be an outlet for the person’s anger and frustration.

Disinhibition

There may be a loss of control over social behaviour, so that the person may behave in an over-familiar manner or may make sexual advances with the wrong people at the wrong time.

Impulsiveness

Brain injury can make a person speak or act without thinking things through.

Obsessive behaviour

This can occur for instance a person may be afraid that their possessions will be stolen and may check their belongings repeatedly.

Where can you get help in Cambridgeshire and Peterborough?

At the time of injury

It is imperative that following an injury to your head, or if you feel you might be suffering a stroke you must call 999 immediately, and get to hospital as quickly as possible.

Afterwards

After having a brain injury, a person will be supported by the GP and dependent on the impairment, the NHS will offer support in other ways, for instance from therapists, attendance at a head injury clinic or even support in the community. However that may not be enough to give the practical and emotional support that is needed.

Improving life after brain injury

Headway Cambridgeshire provides specialist services and support to people with an acquired brain injury and other neurological conditions and their families across the county.

Since 1989 we have been helping people to live as independently as possible in their communities helping them achieve their full potential.

Brain injury can affect anyone, at any time and Headway Cambridgeshire, an autonomous charity, supports individuals and their families through these life-changing events, treating clients as individuals and building a bespoke service to meet their needs and aspirations.

Wherever you live in Cambridgeshire or Peterborough, we can support you either at one of our hubs, in the community or at home.